Diagnosis Of Colorectal Cancer Research Articles

Predictors and Outcomes of Mental Health Conditions Among Patients with Colorectal Cancer.

Mental health (MH) conditions are common in patients with colorectal cancer (CRC) due to the unique challenges these patients encounter. The primary aim was to investigate predictors of new onset MH conditions after a diagnosis of CRC and determine the association of new MH conditions on survival. A single institution, retrospective study was conducted. A multivariable Fine-Gray competing risks model was used to describe the primary study outcome of new MH diagnosis in patients at least 18years of age with CRC. Survival was modeled using Cox proportional hazards regression with a time-varying covariate for new MH diagnosis. 456 patients were identified for inclusion, with 16% developing a new MH condition and 29% dying during follow-up. A new MH condition was more likely among non-Hispanic white patients compared to non-Hispanic black and were less likely among those who are male or had a pre-cancer MH condition. The onset of a new MH condition was associated with a threefold decrease in survival. In addition, having a pre-cancer MH condition decreased survival nearly twofold. Our findings emphasize the importance of new-onset MH in patients after CRC diagnosis. Standardized screenings may alleviate some of the MH burden that patients with CRC experience in addition to potentially improving the overall health of patients. MH conditions may impact not only CRC outcomes but may direct future studies analyzing the risks of new onset MH conditions in other types of cancers, further expanding the importance of psychiatric support in patients with cancer.

Serum zonulin and colorectal cancer risk.

Intestinal permeability has been related to colorectal cancer (CRC) development. Zonulin, a protein able to regulate tight junction function and intestinal permeability, emerges as a promising marker to elucidate the contribution of bacterial translocation in CRC. An Italian case-control study included 77 CRC cases, 72 intestinal adenoma and 76 healthy controls (for a total of 148 tumor-free subjects), aged 20-85. Serum zonulin levels were quantified by ELISA kit and blood 16S rRNA gene copies by DNA extraction and polymerase chain reaction. We applied logistic regression models adjusted for center, sex, age and education. There was a positive association between zonulin and CRC risk. The odds ratio (OR) of CRC for the highest versus lowest tertile of zonulin as compared to tumor-free subjects was 2.36 (95% confidence interval, 1.14-4.86). The ORs were similar in colon and rectal cancers. The OR of colon cancer for the highest versus lowest levels of both zonulin and 16S rRNA gene copies was 4.55.Circulating levels of zonulin were higher in CRC patients compared to tumor-free controls supporting the hypothesis of an interplay of gut barrier dysfunction and bacterial translocation in colorectal carcinogenesis. Zonulin may interact with 16S rRNA gene copies and serve as a further biomarker in the evaluation of CRC diagnosis.

The tissue and circulating cell‐free DNA‐derived genetic landscape of premalignant colorectal lesions and its application for early diagnosis of colorectal cancer

AbstractColorectal adenomas (CRAs) represent precancerous lesions that precede the development of colorectal cancer (CRC). Regular monitoring of CRAs can hinder the progression into carcinoma. To explore the utility of tissue DNA and circulating cell‐free DNA (cfDNA) in early diagnosis of CRC, we retrospectively sequenced paired tissue and plasma samples from 85 patients with conventional CRAs. The genetic alterations identified were compared with those from 78 stage‐I CRC patients (CRC‐I) in the ChangKang project. Within the CRA cohort, we pinpointed 12 genes, notably APC, KRAS, and SOX9, that exhibited significant mutated rates in tissue. Patients harboring KMT2C and KMT2D mutations displayed persistent polyps. By comparing with the mutational profiles of metastatic CRC plasma samples, we found that ZNF717 was exclusively mutated in CRAs, while KMT2C and KMT2D mutations were detected in both CRA and CRC. The presence of cfDNA mutations in plasma was validated through polymerase chain reaction, enhancing the feasibility of using cfDNA mutations for early CRC screening. Compared with CRC‐I, CRAs exhibited a reduced frequency of TP53 and PIK3CA somatic mutations and underwent non‐neutral evolution more often. We established a random forest model based on 15 characteristic genes to distinguish CRA and CRC, achieving an area under the curve of 0.89. Through this endeavor, we identified two novel genes, CNTNAP5 and GATA6, implicated in CRC carcinogenesis. Overall, our findings reveal convincing biomarkers markers for detecting CRAs with a propensity for CRC development, highlighting the importance of early genetic screening in CRC prevention.

Colon cancer screening programs prevent cancer

In this article we comment on the article by Agatsuma et al . Our article focuses on the use of screening for colon cancer increases the likelihood of early diagnosis of colorectal cancer compared to those presenting after symptoms develop. Patients with symptoms were more likely to have left-sided lesions with resultant hematochezia and/or changes in bowel habits. In this study almost all patients in the screen group were first screened with immunochemical fecal occult blood testing. Colonoscopy was used either if it was thought to be the more appropriate initial screening modality or if the non-invasive test was positive. The exact timing when an initial screening colonoscopy should be performed is not totally clear from this study. However, early screening for colon cancer does reduce the risk of cancer diagnosis and more advanced cancer diagnoses.

Abstract A045: Evaluating the potential of micronuclei DNA from erythrocytes for early detection of colorectal cancer

Abstract Background: Current development in stool- and cell-free DNA (cfDNA)-based technologies have demonstrated promising potentials in colorectal cancer (CRC) diagnosis. However, early detection of CRC and advanced adenoma (AA) remains challenging. Micronuclei (MN) are extranuclear bodies containing chromatin segments resulting from errors in DNA repair. Elevated levels of MN+ erythrocytes have been studied in genotoxicity testing and cancer diagnosis. We further performed whole-genome sequencing on purified and isolated micronuclei DNA (MN-DNA) from erythrocytes in peripheral blood using the approach (WO2021/228246 A1) we previously developed. By comparing MN-DNA from colorectal cancer (CRC) patients and healthy individuals, we identified a series of tumor-associated MN-DNA features (taMN- DNA) with significant differences in read counts and developed a classification model. Here, we established an independent cohort to clinically validate the CRC model and explore its application in early cancer diagnosis. Methods: We launched a prospective observational case- control clinical trial (NCT05875584), which was used as an independent cohort to validate taMN-DNA features in CRC and to perform a comparative analysis with quantitative fecal immunochemical test (qFIT). A total of 598 samples were enrolled in this study (585 was available, including 299 HDs, 206 AAs, and 80 CRCs). We gathered peripheral blood (1-2ml) from a training cohort of 1226 individuals, a test cohort of 309 individuals and this independent cohort of 598 individuals for the MN-DNA isolation from erythrocytes and whole-genome sequencing. Predictive models were developed using distinctive taMN-DNA features identified by genome-wide analysis from training cohort to differentiate between HD and AA or CRC. Results: The predictive CRC model built on taMN-DNA features achieved an AUC of 93% and the detection of AA achieved an AUC of 82% in this clinical validation cohort. Comparing MN-DNA with qFIT, the overall sensitivity was generally consistent (91.3% vs. 87.5%), with MN-DNA achieving 86.4% sensitivity in early-stage (stage I) CRC, significantly higher than 68.2% in qFIT. Additionally, MN-DNA showed superior sensitivity in detecting AA (71.4% vs. 18.4%), with comparable specificity (90.3% vs. 96.3%). Conclusions: Our results demonstrate that MN-DNA within erythrocytes from 1-2ml peripheral blood enable accurate detection of AA and early-stage CRC. Research sponsor: Timing Biotech. Citation Format: Yurong Jiao, Xingyun Yao, Haobo Sun, Chengcheng Liu, Xiangxing Kong, Honghao Liang, Fei Meng, Jun Li, Kefeng Ding, Xiaofei Gao. Evaluating the potential of micronuclei DNA from erythrocytes for early detection of colorectal cancer [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr A045.

Associations Between Dietary Patterns and Quality of Life in a Longitudinal Cohort of Colorectal Cancer Survivors

Purpose: To characterize dietary patterns and examine associations with cross-sectional and longitudinal changes in quality of life (QOL) over approximately one year after colorectal cancer (CRC) diagnosis. Methods: The ColoCare Study is an international, multi-center, prospective cohort study of newly diagnosed CRC survivors of any stage. A subset of participants with CRC in the United States completed patient-reported outcome measures at 6- and 12-months post-enrollment, including the Food Frequency Questionnaire (FFQ) and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Dietary patterns at 6 months (around the time of treatment completion) were identified using Principal Component Analysis (PCA) with varimax rotation. Adherence scores were calculated for participants within each dietary pattern, with higher scores indicating higher adherence. Mixed models were used to examine the effect of each dietary pattern on changes in QOL at 6- and 12-month follow-ups, controlling for cancer stage, biological sex, body mass index (BMI), smoking status, and age. Results: Participants (N = 174) were, on average, 56 ± 14 years old and were mostly female (51.5%), stage III or IV (51.7%), never smokers (60.2%), non-Hispanic (97.1%), and White (83.3%) with a BMI of 27.9 ± 6.1 kg/m2. PCA revealed two emerging dietary patterns: “Western diet”, characterized by processed meats, refined grains, and sugars, and “Prudent diet” characterized by lean proteins, fruits, and vegetables. Higher adherence to a Western diet was associated with worse social functioning at 6-month follow-up (FE = −12.6, p = 0.010). Loss of appetite from 6 to 12 months was associated with higher adherence to both the Western and Prudent dietary patterns (FE = 1.5, p = 0.044; FE = 1.3, p = 0.046, respectively). Neither dietary pattern was associated with global QOL score at 6- or 12-month follow-up (p’s > 0.05). Conclusions: Among CRC survivors in the United States, the Western diet was concurrently associated with worse social functioning. Loss of appetite was reported by CRC survivors following both dietary patterns, suggesting that loss of appetite may be a global experience for CRC survivors during this timeframe. Further research is needed to understand specific social challenges experienced by CRC survivors and develop supportive care interventions to address appetite and nutritional concerns.

AER-Net: Attention-Enhanced Residual Refinement Network for Nuclei Segmentation and Classification in Histology Images

The acurate segmentation and classification of nuclei in histological images are crucial for the diagnosis and treatment of colorectal cancer. However, the aggregation of nuclei and intra-class variability in histology images present significant challenges for nuclei segmentation and classification. In addition, the imbalance of various nuclei classes exacerbates the difficulty of nuclei classification and segmentation using deep learning models. To address these challenges, we present a novel attention-enhanced residual refinement network (AER-Net), which consists of one encoder and three decoder branches that have same network structure. In addition to the nuclei instance segmentation branch and nuclei classification branch, one branch is used to predict the vertical and horizontal distance from each pixel to its nuclear center, which is combined with output by the segmentation branch to improve the final segmentation results. The AER-Net utilizes an attention-enhanced encoder module to focus on more valuable features. To further refine predictions and achieve more accurate results, an attention-enhancing residual refinement module is employed at the end of each encoder branch. Moreover, the coarse predictions and refined predictions are combined by using a loss function that employs cross-entropy loss and generalized dice loss to efficiently tackle the challenge of class imbalance among nuclei in histology images. Compared with other state-of-the-art methods on two colorectal cancer datasets and a pan-cancer dataset, AER-Net demonstrates outstanding performance, validating its effectiveness in nuclear segmentation and classification.

Exchangeable Copper Excess and Zinc Deficiency in the Serum of Patients with Colorectal Cancer.

Copper (Cu) and Zinc (Zn) are altered in colorectal cancer (CRC) but their association with the clinical classification of the tumor has not been fully explored. To examine the association of Cu and Zn homeostasis in the onset and severity of CRC, we performed an exploratory case-control study comparing the serum levels for Cu, the exchangeable component of Cu in serum (CuExc), Zn, the ratio between them (CuExc:Zn), ceruloplasmin [Cp, concentration (iCp) and its activity (eCp), Cp specific activity (eCp:iCp)], and the Cu:Cp, assessed in 31 consecutive CRC patients before surgical resection to those obtained from 37 healthy controls (CTRL). Additionally, we correlated the analyte levels with the indices of the pathological tumor, node, and metastasis (TNM) staging, namely tumor (T), node (N), and metastasis (M), evaluated at the histopathological examination. We found that Cu, CuExc, CuExc:Zn, iCp, eCp, eCp:iCp, and Cu:Cp ratios increased while Zn decreased in CRC patients. In addition, correlation analyses showed that CuExc and Zn levels confirmed the CRC diagnosis. Specifically, CuExc:Zn further increased the discrimination between the individuals of the two groups, providing an area under the curve (ROC AUC) = 0.94. Elevated CuExc was the strongest factor associated with CRC resulting in 15-fold increased odds. These data were confirmed through a multivariable regression model revealing an effect of Zn and CuExc on the CRC risk, with the CuExc resulting in 11-fold increased odds of having the disease. We also found that most of the Cu biological variables analyzed were associated with T, while the CuExc was associated with M. The current pilot study demonstrates that excess labile Cu pool, Zn deficiency, and even further their combination in the CuExc:Zn provide information about CRC in terms of diagnosis, risk of having CRC, and CRC disease stage.

USING ARTIFICIAL INTELLIGENCE FOR BIOMARKER ANALYSIS IN CLINICAL DIAGNOSTICS

Introduction. Artificial intelligence (AI) technologies are becoming crucial in clinical diagnostics due to their ability to process and interpret large volumes of data. The implementation of AI for biomarker analysis opens new opportunities in personalized medicine, offering more accurate and individualized approaches to disease diagnosis and treatment. The relevance of this review stems from the need to systematize recent advances in AI application for biomarker analysis, which is critical for early diagnosis and prediction of chronic non-communicable diseases (NCDs). Material and methods. The analysis of peer-reviewed scientific publications and reports from leading research centers over the past five years was conducted. Studies on the application of AI algorithms for analyzing genomic, proteomic, and metabolomic biomarkers were reviewed, including machine learning methods and deep neural networks. Special attention was paid to the integration of multi-marker panels for improving the accuracy of diagnosis and prediction of cardiovascular, digestive, respiratory, endocrine system diseases, as well as oncological and neurodegenerative pathologies. Results. The application of AI has significantly increased the sensitivity and specificity of diagnostics, especially in complex cases requiring analysis of multiple disease parameters. The effectiveness of AI has been demonstrated in early diagnosis of lung, breast, and colorectal cancer, prediction of cardiovascular complications and NCDs progression, including diabetes mellitus and Alzheimer’s disease. AI’s significant contribution to the discovery of new biomarkers, optimization of personalized treatment, and improvement of therapeutic strategies has been noted. Conclusion. The use of AI in biomarker analysis has become a significant breakthrough in medical diagnostics, particularly in oncology, cardiology, and neurodegenerative diseases. The technology allows integration of data about various biomarkers and contributes to creating more accurate models for disease diagnosis and prediction. Further development is associated with technology advancement and overcoming ethical and regulatory barriers, which will expand AI capabilities in clinical practice.

Colonoscopy is associated with lower colorectal cancer occurrence and mortality in the older population: A population-based cohort study.

We aimed to evaluate the association between colonoscopy (CS) and colorectal cancer (CRC) occurrence and related mortality in an older population. This retrospective, nationwide, population-based cohort study used data of adults aged ≥40 years from the Health Insurance Review and Assessment Service database. After excluding CS within 6 months of CRC diagnosis during enrollment, CRC occurrence and related mortality were compared between CS and non-CS groups using a time-dependent Cox proportional hazard model. Sub-group analysis was conducted among four age groups: young, middle age, old, and very old. Results Among 748,989 individuals followed for 9.64±0.99 years, the CS group had a 65% lower CRC occurrence (adjusted hazard ratio [HRa]: 0.35, 95% confidence interval [95%CI]: 0.32-0.38) and 76% lower CRC-related mortality (HRa: 0.24, 95%CI: 0.18-0.31) after 5 years than the non-CS group. CS was associated with the most significant reduction in CRC occurrence in the middle age group (HRa: 0.32, 95%CI: 0.29-0.35) and CRC-related mortality in the young age group (HRa: 0.04, 95%CI: 0.01-0.33); the very old age group had the least reduction in both CRC occurrence and CRC-related mortality (HRa: 0.44, 95%CI: 0.33-0.59 and HRa: 0.28, 95%CI: 0.15-0.53, respectively). Conclusion We found a significant association between colonoscopy and reduction in CRC occurrence and CRC-related mortality in adults aged ≥ 40 years after 5 years of follow-up; however, these associations were weaker in the very old group. Research is needed on the association between colonoscopy and older age.

Early colorectal cancer diagnosis: A novel methylated stool DNA model enhanced the diagnostic efficiency.

Methylated stool DNA (sDNA) is a reliable noninvasive biomarker for early colorectal cancer (CRC) diagnosis. However, there are barely any diagnostic panels that can achieve both a sensitivity and specificity exceeding 90% simultaneously. We aimed to identify a novel methylated sDNA panel and model for the early diagnosis of CRC. We conducted methyl-CpG binding domain isolated genome sequencing (MiGS) on CpG island methylation phenotype (CIMP)-positive (n=3) and CIMP-negative CRC tissues (n=3) and their corresponding normal adjacent tissues. Subsequently, by utilizing both the aforementioned data and public datasets, we identified a set of promising methylated sDNA markers for CRC. Next, we validated 5 of these genes using pyrosequencing in CRC patients (n=31). Then, we developed a combined diagnostic model (CDM) for CRC based on the methylation status of PRDM12, FOXE1, and SDC2 by a Training cohort (n=231). Finally, the performance of CDM was evaluated in an independent multicenter Validation cohort (n=800). A total of 1062 participants were included in this study. The area under the curve (AUC) of the CDM was 0.979 (95% CI: 0.960-0.997), and the optimal sensitivity and specificity were 97.35% and 99.05%, respectively, in the training cohort (n=231). In the independent validation cohort (n=800), the AUC was 0.950 (95% CI: 0.927-0.973), along with the optimal sensitivity of 92.75% and specificity of 97.21%. When CRC and advanced adenoma (AAD) were used as diagnostic targets, the model AUC was 0.945 (95% CI: 0.922-0.969), with an optimal sensitivity of 91.89% and a specificity of 95.21%. The model sensitivity for nonadvanced adenoma patients was 68.66%. The sDNA diagnostic model CDM, developed from both CIMP-P and CIMP-N, exhibited exceptional performance in CRC and could serve as a potential alternative strategy for CRC screening.

Application of Nanoparticles in the Diagnosis and Treatment of Colorectal Cancer.

Colorectal cancer is a common malignant tumor with high morbidity and mortality rates, imposing a huge burden on both patients and the healthcare system. Traditional treatments such as surgery, chemotherapy and radiotherapy have limitations, so finding more effective diagnostic and therapeutic tools is critical to improving the survival and quality of life of colorectal cancer patients. While current tumor targeting research mainly focuses on exploring the function and mechanism of molecular targets and screening for excellent drug targets, it is crucial to test the efficacy and mechanism of tumor cell therapy that targets these molecular targets. Selecting the appropriate drug carrier is a key step in effectively targeting tumor cells. In recent years, nanoparticles have gained significant interest as gene carriers in the field of colorectal cancer diagnosis and treatment due to their low toxicity and high protective properties. Nanoparticles, synthesized from natural or polymeric materials, are NM-sized particles that offer advantages such as low toxicity, slow release, and protection of target genes during delivery. By modifying nanoparticles, they can be targeted towards specific cells for efficient and safe targeting of tumor cells. Numerous studies have demonstrated the safety, efficiency, and specificity of nanoparticles in targeting tumor cells, making them a promising gene carrier for experimental and clinical studies. This paper aims to review the current application of nanoparticles in colorectal cancer diagnosis and treatment to provide insights for targeted therapy for colorectal cancer while also highlighting future prospects for nanoparticle development.

Evaluation of Fluctuations of BRAF Gene Expression and its Polymorphism at rs1267623 in Colorectal Cancer.

Molecular markers in Colorectal Cancer (CRC) are needed for more ac-curate classification and personalized treatment. In this way, we investigated the effects of the BRAF gene on clinical outcomes of its expression fluctuations and its polymorphism at rs1267623 in CRC. In this study, 36.36 percent of patients with CRC were women, and 63.63 percent were men. After the pathology department confirmed the tumor of the samples, the stage and grade of the tumor were determined according to the TNM system. Real-time PCR was used to check the expression of the BRAF gene in tumor and non-tumor tissues, and its polymorphism in rs1267623 was also checked using the Tetra-ARMs PCR technique. The expression of BRAF in tumor tissues was significantly higher than in non-tumoral tissues (P = 0.001), indicating an upregulation of BRAF gene expression in tumoral tissues. The user's text is empty. Furthermore, there was a significant correlation between BRAF expression and tumor stage (P = 0.001), as well as tumor grade (P = 0.003). However, no significant link was found between lymph node metastasis and distant metastasis of BRAF gene expression (P = 0.3). Additionally, no mutation was detected in the investigation of rs1267623 polymorphism. The BRAF gene was upregulated in tumoral tissues. Remarkably, no mutation was found in the rs1267623 polymorphism. As a result, this gene can be used as a biomarker in the diagnosis and treatment of CRC.

Clinical Significance of HHLA2 as a Novel Therapeutic Target for Colorectal Cancer.

Colorectal cancer (CRC) is a high-indence malignance of the digestive system with a high mortality rate in the world. The results are desired to provide an important theoretical basis for discovering new therapeutic targets for CRC. The expression of human endogenous retrovirus-H-long terminal repeat association protein 2 (HHLA2) in human CRC was detected to explore its correlationship with clinicopathological features and prognosis of patients and its potential in treating CRC. Western blot was employed to detect HHLA2 expression in fresh tissues obtained from 6 CRC patients' excisions, including cancer, paracancer, and normal issues. Immunohistochemical staining was employed to determine HHLA2 expression in paraffin-embedded specimens of 139 patients with colorectal cancer, and its relationship with the clinicopathological profiles and survival was analyzed. Small interfering RNA (siRNA) targeting HHLA2 was used to transfect CRC cells to silent HHLA2. MTT, plate colony formation, cell scratch, and Transwell assay were conducted to observe the proliferation, migration, and invasion of CRC cells. HHLA2 protein was expressed in human colorectal cancer tissues, paracancer tissues and normal tissues, which was significantly upregulated in cancer tissues (P<0.01). HHLA2 expression level in CRC tissues showed a close correlationship with the invasion depth of the tumor (P=0.000), metastasis of regional lymph nodes (P=0.018), clinical stage (P=0.010), and patient survival (P=0.011). Correlation with gender (P=0.873), age (P=0.864), location of the tumor (P=0.768), degree of tumor differentiation (P=0.569) and distant metastasis (P=0.494) exhibited no significance. The survival time of CRC patients with high and low HHLA2 expression groups was 43.231 months and 55.649 months, respectively, with a statistical difference between the two groups (P=0.001). Silencing HHLA2 inhibited proliferation, migration and invasion of CRC cells significantly. HHLA2 is overexpressed in CRC tissues which is associated with poor prognosis of patients. HHLA2 might be recognized as a new candidate for adjuvant diagnosis and prognosis of CRC, as well as a promised new target for immunotherapy of CRC.

GUCA2A dysregulation as a promising biomarker for accurate diagnosis and prognosis of colorectal cancer

Colorectal cancer is a leading cause of global mortality and presents a significant barrier to improving life expectancy. The primary objective of this study was to discern a unique differentially expressed gene (DEG) that exhibits a strong association with colorectal cancer. By achieving this goal, the research aims to contribute valuable insights to the field of translational medicine. We performed analysis of colorectal cancer microarray and the TCGA colon adenoma carcinoma (COAD) datasets to identify DEGs associated with COAD and common DEGs were selected. Furthermore, a pan-cancer analysis encompassing 33 different cancer types was performed to identify differential genes significantly expressed only in COAD. Then, comprehensively in-silico analysis including gene set enrichment analysis, constructing Protein–Protein interaction, co-expression, and competing endogenous RNA (ceRNA) networks, investigating the correlation between tumor-immune signatures in distinct tumor microenvironment and also the potential interactions between the identified gene and various drugs was executed. Further, the candidate gene was experimentally validated in tumoral colorectal tissues and colorectal adenomatous polyps by qRael-Time PCR. GUCA2A emerged as a significant DEG specific to colorectal cancer (|log2FC|> 1 and adjusted q-value < 0.05). Importantly, GUCA2A exhibited excellent diagnostic performance for COAD, with a 99.6% and 78% area under the curve (AUC) based on TCGA-COAD and colon cancer patients. In addition, GUCA2A expression in adenomatous polyps equal to or larger than 5 mm was significantly lower compared to smaller than 5 mm. Moreover, low expression of GUCA2A significantly impacted overall patient survival. Significant correlations were observed between tumor-immune signatures and GUCA2A expression. The ceRNA constructed included GUCA2A, 8 shared miRNAs, and 61 circRNAs. This study identifies GUCA2A as a promising prognostic and diagnostic biomarker for colorectal cancer. Further investigations are warranted to explore the potential of GUCA2A as a therapeutic biomarker.

The ketogenic diet modulates tumor-associated neutrophil polarization via the AMOT-YAP/TAZ axis to inhibit colorectal cancer progression

Despite significant advances in the diagnosis and treatment of colorectal cancer (CRC), the prognosis for late-stage patients remains poor, highlighting the urgent need for new preventive and therapeutic strategies. Recent studies have focused on the ketogenic diet (KD) and its metabolite, β-hydroxybutyrate (BHB), for their tumor-suppressive effects and modulation of inflammatory responses. Using the azoxymethane (AOM) / dextran sulfate sodium (DSS)-induced mouse CRC model, we found that the ketogenic diet and BHB inhibit pro-tumor N2-type tumor-associated neutrophils (TANs) while promoting the polarization of TANs towards the anti-tumor N1 type. This shift in TANs polarization affects tumor growth and metastasis. The underlying mechanism involves BHB acting on the intracellular receptor histone deacetylases 3 (HDAC3), which modulates the activation of the AMOT-YAP/TAZ axis, leading to the inhibition of pro-carcinogenic factor transcription and release. Moreover, clinical cohort data corroborate these findings, showing that CRC patients with elevated BHB levels have significantly lower rates of lymph node involvement, which is associated with a higher infiltration ratio of anti-carcinogenic N1-type TANs in the tumor microenvironment (TME). These results suggest that BHB levels could serve as a prognostic biomarker for CRC. In conclusion, our findings indicate that BHB derived from KD regulates TANs polarization in CRC via the HDAC3-AMOT-YAP/TAZ axis, effectively inhibiting tumor growth and metastasis. These insights establish a novel theoretical basis for employing the KD in the treatment of CRC and for developing cancer adjuvant immunotherapy strategy based on the polarization of neutrophils.

Raman spectroscopy on dried blood plasma allows diagnosis and monitoring of colorectal cancer.

Colorectal cancer (CRC) remains challenging to diagnose, necessitating the identification of a noninvasive biomarker that can differentiate it from other conditions such as inflammatory bowel diseases (IBD) and diverticular disease (DD). Raman spectroscopy (RS) stands out as a promising technique for monitoring blood biochemical profiles, with the potential to identify distinct signatures identifying CRC subjects. We performed RS analysis on dried plasma from 120 subjects: 32 CRC patients, 37 IBD patients, 20 DD patients, and 31 healthy controls. We also conducted longitudinal studies of CRC patient's postsurgery to monitor the spectral changes over time. We identified six spectral features that showed significant differences between CRC and non-CRC patients, corresponding to tryptophan, tyrosine, phenylalanine, lipids, carotenoids, and disulfide bridges. These features enabled the classification of CRC patients with an accuracy of 87.5%. Moreover, longitudinal analysis revealed that the spectral differences normalized over 6 months after surgery, indicating their association with the presence of the disease. Our study demonstrates the potential of RS to identify specific biomolecular signatures related to CRC. These results suggest that RS could be a novel screening and monitoring tool, providing valuable insights for the development of noninvasive and accurate diagnostic methods for CRC.

Diagnosis of Colorectal Cancer and Adenomatous Polyps of the Colon Based on the Level of MicroRNA Expression in the Mucous Membrane (Pilot Clinical Study)

Diagnosis of Colorectal Cancer and Adenomatous Polyps of the Colon Based on the Level of MicroRNA Expression in the Mucous Membrane (Pilot Clinical Study)

The role of PIK3CA gene mutations in colorectal cancer and the selection of treatment strategies

PIK3CA gene encodes the p110α catalytic subunit of PI3K, which regulates the PI3K/AKT/mTOR signaling pathway. PIK3CA gene mutation is one of the most common mutations in colorectal cancer (CRC), affecting about 15%–20% of CRC patients. PIK3CA gene mutation leads to the persistent activation of the PI3K/AKT/mTOR signaling pathway, which promotes the proliferation, invasion, metastasis, and drug resistance of CRC. This article provides a summary of the key detection methods for PIK3CA gene mutation, and provides an introduction to the existing colorectal cancer treatments and their practical applications in the clinic. Besides, this article summarizes the role and mechanism of PIK3CA gene mutation in the occurrence and development of CRC. It also explores the relationship between PIK3CA gene mutation and the clinical features and prognosis of CRC. This article focuses on the influence and mechanism of PIK3CA gene mutation on the targeted therapy and immunotherapy of CRC, and discusses the potential value and future direction of PIK3CA gene mutation in the personalized therapy of CRC. We aim to provide new perspectives and ideas for the precise diagnosis and treatment of CRC.

TYK2 Protein Expression and Its Potential as a Tissue-Based Biomarker for the Diagnosis of Colorectal Cancer.

The aim of this study was to examine the expression of TYK2 in colorectal cancer (CRC) and to determine the potential diagnostic and prognostic significance of this kinase. Digital image analysis was performed to assess immunohistochemical TYK2 reactivity. There were significant differences for all positive pixels between CRC and normal colonic mucosa, with higher TYK2 expression levels observed in surgical margins than in adenocarcinomas (p = 0.0004). Paired t tests showed elevated immunoreactivity for overall TYK2 expression in matched pairs of CRC with adjacent surgical margins (p < 0.0001). Higher percentages of weak (p < 0.0001) and strong pixels (p = 0.0260) were detected in normal colonic mucosa than in cancer tissues. To distinguish cancer from normal intestinal mucosa, the following cutoffs for the TYK2 immune score were found: 29.5% for all cases and 31% for matched pairs. Tumor budding (Bd) was negatively correlated with the percentage of strong pixels for TYK2 (ρ = -0.270, p = 0.0096). The percentage of strong pixels was significantly elevated for the T parameter (p = 0.0428). There was a positive correlation between the number of involved lymph nodes and weak pixels (ρ = 0.239, p = 0.0242). Immunofluorescence staining showed significantly higher signal intensities in colonic mucosa than in CRC. The protein level of TYK2 was significantly higher in controls than in cancer tissues. TEM imaging showed lower levels of TYK2 in cancer than in ulcerative colitis. TYK2 protein expression may bring diagnostic value in patients diagnosed with CRC.